Cuts force Allentown Health Department to retrench

Loss of $90,000, Affordable Care Act requirements mean changes

August 01, 2012|By Scott Kraus, Of The Morning Call

The Allentown Health Department will have to figure out how to make do with $90,000 less in state public health funding this year.

The cuts, included in larger funding reduction spread across all local health departments in the state, were relayed by the Corbett Administration on Tuesday night to Allentown Health Director Vicki Kistler, who reported the reduction to city council Wednesday.

The reduced funding, plus changes in federal health policy included in the Affordable Care Act could mean big changes in the way the city handles public health services and vaccinations this year, she said, and will likely put more stress on primary care doctors.

To stretch its funding, Kistler said the department will have to be much stricter in determining who is eligible for assistance, limiting recipients or health department services to city residents only to conserve resources.

"We will have to institute very, very strict residency requirements," Kistler said.

That means college students whose primary residence is outside the city, people who work in the city but don't live there, and relatives of city residents will likely be told to go elsewhere if they need health services.

The Allentown Health Department has a total budget of about $2.9 million, up from last year, but less than in 2007, said Councilman Michael Schlossberg. About $646,000 of that comes from the state, so a $90,000 cut amounts to close to a 14 percent reduction.

The state failed to make its first and second quarter funding payments, Kistler said, notifying the health department retroactively on July 3 that its funding for the first half of 2012 had been cut $66,000 because of a $2.9 million shortfall in the State Health Department budget.

"I can't fathom that a state is going to have a $2.9 million deficit in the Health Department budget and they don't know that is coming until they allow us to do six months worth of spending," Kistler said. "They are draconian cuts."

The city learned of the additional $23,000 in cuts for the second half of the year in the letter it received on Tuesday, Kistler said.

Luckily, she said the city planned for cuts to state funding, so she won't have to make up for all $90,000. It's also aggressively pursuing public and private sector grants.

The department will also be adjusting to federal health reforms that change the way the city administers vaccinations, she said.

Starting in October, with the exception of this year's flu vaccination program, the city will be prohibited from providing vaccinations to anyone with health insurance of any form, whether it's private or public, such as Medicare or Medicaid.

"Our taxpayers who have gotten accustomed to coming to get a vaccine, you are going to have to have to make an appointment with your doctor, or wait in line at a Walgreens," Kistler said.

A typical example would be providing whooping cough vaccinations to expectant parents with limited insurance to prevent them from infecting their newborn, she said, or providing a vaccination to an elderly shut-in on Medicare.

Kistler said she understands the goal of the federal reforms, which is to get people to form a relationship with a primary care physician, but that in Allentown it can take time to make an appointment with one of the shrinking pool of doctors that accepts programs like Medicaid and the Childrens Health Insurance Program.

That could mean children out of school for weeks because they lack adequate vaccinations.

"The primary care providers are going to get more people sent in their direction," she said.